H.B. No. 412 aims to enhance health benefit plan coverage for early childhood intervention services in Texas. The bill amends the Insurance Code to include early childhood intervention services in the heading of Subchapter E, Chapter 1367, and expands the definition of rehabilitative and habilitative therapies to encompass specialized skills training by certified early intervention specialists, applied behavior analysis treatment by licensed professionals, and case management services. Additionally, the bill specifies that health benefit plans must provide coverage for these services as outlined in a child's individualized family service plan, with certain provisions regarding annual limits and prior authorization requirements.

The legislation also prohibits health benefit plan issuers from applying annual or lifetime maximums to the cost of these therapies, ensuring that children receive necessary services without financial barriers. It establishes that coverage for specialized skills training may be subject to an annual limit of $9,000, while ensuring that this limit does not affect coverage for other therapies or services mandated by law. The bill is set to take effect on September 1, 2025, and will apply to health benefit plans delivered, issued, or renewed on or after January 1, 2026.

Statutes affected:
Introduced: Insurance Code 1367.201, Insurance Code 1367.202, Insurance Code 1367.204, Insurance Code 1367.205, Insurance Code 1367.206 (Insurance Code 1367)